MEDICAL IMAGING DATABASES

NIH GUIDE, Volume 22, Number 32, September 3, 1993



PA NUMBER:  PA-93-107



P.T. 34



Keywords:

  Instrumentation, Medical 

  Computer Storage & Retrieval 

  Medical/Diagnostic Imaging 



National Cancer Institute

National Institute of Neurological Disorders and Stroke

National Library of Medicine



PURPOSE



The National Cancer Institute (NCI) through the Diagnostic Imaging

Research Branch (DIRB) of the Radiation Research Program, the National

Library of Medicine (NLM), and the Division of Stroke and Trauma,

National Institute of Neurological Disorders and Stroke (NINDS) are

seeking grant applications that will address new medical imaging

database designs that focus on non-textual paradigms.  The goal of

medical imaging databases is to provide a means for organizing a large

mass of heterogeneous, changing, pictorial, and symbolic data into a

structured environment that can be synthesized, classified, and

presented in an organized efficient manner to facilitate optimal

decision making in a health care environment.  A properly organized

imaging database can compensate for human memory limitations and

provide an environment for improved patient care, research, and

education.  Development of an effective and useful medical imaging

database must take place in an interdisciplinary environment, using the

medical knowledge from radiologists, radiation and medical oncologists,

neurologists and other specialties in collaboration with the database

research community and the imaging expertise of the computer and

Picture Archiving and Communications System (PACS) sciences.



HEALTHY PEOPLE 2000



The Public Health Service (PHS) is committed to achieving the health

promotion and disease prevention objectives of "Healthy People 2000,"

a PHS-led national activity for setting priority areas.  This program

announcement, Medical Imaging Databases, is related to the priority

area of cancer.  Potential applicants may obtain a copy of "Healthy

People 2000" (Full Report:  Stock No. 017-001-00474-0) or "Healthy

People 2000" (Summary Report:  Stock No. 017-001-00473-1) through the

Superintendent of Documents, Government Printing Office, Washington, DC

20402-9325 (telephone 202-783-3238).



ELIGIBILITY REQUIREMENTS



Applications may be submitted by foreign and domestic, for-profit and

non-profit, public and private organizations, such as universities,

colleges, hospitals, laboratories, units of State and local governments

and eligible agencies of the Federal government.  Applications from

minority individuals and women are encouraged.  Foreign institutions

are not eligible for First Independent Research Support and Transition

Awards (R29).



MECHANISM OF SUPPORT



Applications considered appropriate responses to this announcement are

the traditional research project grants (R01) and the First Independent

Research Support and Transition (FIRST) award (R29).  Although no funds

are specifically set aside for funding grants submitted in response to

this program announcement, the Radiation Research Program regards

research in this area as high priority.



Awards will be administered in accordance with PHS grants policy as

described in the PHS Grants Policy Statement, DHHS, Publication No.

(OASH) 90-50,000 revised October 1, 1990.



Because of the nature and scope of the research proposed in response to

this Program Announcement may vary, it is anticipated that the size of

an award will vary also.



RESEARCH OBJECTIVES



Background



Today, medical imaging database management and searches are largely

performed by skilled human investigators.  Although considerable

progress has been achieved in recent years in the development of new

strategies for rapid and efficient textual retrievals from text

databases, very little effort has gone into the development of

techniques for non-textual searches.  Similarly, since medical images

are poorly incorporated into the overall collection of data on cancer

patients, there is very little attempt to cohesively gather information

from images of different patients for correlation with other critical

parameters of their disease.  The wealth of information that is

potentially accessible, but not available through any currently

available technology, would contribute to new clinical knowledge about

disease progression, prognostic indicators for outcome assessment in

patients scheduled for treatment, and the ability to assess outcome in

patients who have undergone treatment.



Research Goals and Scope



Although much research has already been done in the development of

"next generation databases,"  more research is needed to address the

complex issues of developing the tools for medical imaging databases in

a clinical environment.  The research goals of this Program

Announcement include the following:



1.  Development of a descriptive language for medical images that

describes image features that define the oncologic content of images

and develops a standardized vocabulary for the geometric description of

the images;



2.  Development and implementation of advanced query languages that use

pictorial and symbolic-based object-oriented data modeling to support

complex non-textual queries;



3.  Development of new database models that incorporate the following

features:



a.  index an imaging database using image features;



b.  support spatial relations for queries that can detect change, such

as by shape and size, but are robust enough to adjust for deformations;



c.  develop object-oriented solutions that can handle levels of

uncertainty in identifying objects with fuzzy boundaries;



d.  support temporal relations that reflect both the history of the

patient, as is currently best known, as well as what was in the

database at any given point in time;



e.  allow for the development of ad hoc and customized schema that

evolve as the user gathers new data and knowledge by navigating through

or perusing the database;



f.  solve integrity problems, such as resolving a situation when two

databases contain contradictory information;



g.  carry out search and analysis processes that are both accurate and

timely and allow for the interaction of a human investigator.



5.  Development of tools that allow for the cohesive unification of

data and information from hospital information systems, radiological

information systems, image archives and imaging machines into one

system for incorporation into the electronic medical record for

incorporation into the electronic medical record.



Research and implementations of database systems must proceed in

interdisciplinary environments that successfully combine the expertise

and knowledge from the medical community with that of the database and

computer science disciplines.



APPLICATION PROCEDURES



The research grant application form PHS 398 (rev. 9/91) is to be used

in applying for this program announcement and will be accepted at the

standard application deadlines as indicated in the application kit.

These forms are available at most institutional offices of sponsored

research and from the Office of Grants Information, Division of

Research Grants, National Institutes of Health, Westwood Building, Room

449, 5333 Westbard Avenue, Bethesda, MD 20892, telephone

(301-710-0267).



The PA number and title must be typed on line 2a of the face page of

the application form.  The completed original application and five

legible copies must be sent to:



Division of Research Grants

National Institutes of Health

Westwood Building, Room 240

Bethesda, MD  20892**



All PHS and NIH grants policies will apply to applications received in

response to this announcement.



FIRST (R29) award applications must include at least three sealed

letters of reference attached to the face page of the original

application.  FIRST (R29) award applications submitted without the

required number of reference letters will be considered incomplete and

will be returned without review.



REVIEW CONSIDERATIONS



Applications will be assigned on the basis of established PHS referral

guidelines.  Applications will be reviewed for scientific and technical

merit by study sections, in accordance with the standard NIH peer

review procedures.  Following scientific-technical review, the

applications will receive a second-level review by the appropriate

national advisory council.



AWARD CRITERIA



Applications will compete for available funds with all other approved

applications.  The following will be considered in making funding

decisions:



o  Quality of the proposed project as determined by peer review

o  Availability of funds

o  Program balance among the research areas of this announcement



INQUIRIES



Written and telephone inquiries concerning the objectives and scope of

this PA and inquiries about whether or not specific proposed research

would be responsive are encouraged and may be directed to:



Dr. Sandra Zink

Radiation Research Program

National Cancer Institute

Executive Plaza North, Suite 800

Bethesda, MD  20892

Telephone:  (301) 496-9360



Dr.  George N.  Eaves

Division of Stroke and Trauma

National Institute of Neurological Disorders and Stroke

Federal Building, Room 8A-13

Bethesda MD  20892-9905

Telephone:  (301) 496-4226



Dr. Roger Dahlen

Extramural Programs

National Library of Medicine

Building 38, Room 5S522

Bethesda, MD  20892

Telephone:  (301) 496-4221



Direct inquiries regarding fiscal matters to:



Barbara A. Fisher

Grants Management Specialist

National Cancer Institute

Executive Plaza South, Room 242

Bethesda, MD  20892

Telephone:  (301) 496-7800, ext. 66



AUTHORITY AND REGULATIONS



This program is described in the Catalog of Federal Domestic Assistance

Number 93.395, Cancer Treatment Research and Number 93.854, Biological

Basis Research in the Neurosciences.  Awards are made under the

authorization of the Public Health Service Act, Title IV, Part A

(Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and

285) and administered under PHS grants policies and Federal Regulations

42 CFR Part 52 and 45 CFR Part 74.  This program is not subject to the

intergovernmental review requirements of Executive Order 12372 or

Health Systems Agency review.



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